Збірник тез XVI Міжнародно медичного конгресу студентів та ...

Bezpalko Luydmula, Shost Mariya, Pavlyshyn Andriy, Melekh Olena
DERMOPLASTY ON THE ALIMENTARY FOOD AT THE ELECTRICAL HAND TRAUMA OF CHILDREN
Scientific supervisor – Perepelytsya M.P.
Private Higher Educational Establishment «Medical College»
Ternopil, Ukraine
There are 40% of burns among children traumatism. One of the most complicated problems of the burn
traumatism at these patients is electrotrauma, where the hand suffers the most and according to scientific
publications it makes 22,3-47,9%. Inadequate preliminary treatment of electrical hand trauma at children, in
comparison to adults, leads to formation of scar hand deformations, which impends over children‘s disability at
intensive growth, difficulties in social adaptation and decrease of the quality of the following life. One of the
conditions of successful hand treatment at electrotrauma is dermal closure of the injured area. The results of 121
patients‘ treatment with electrical injuries of a hand were analyzed and generalized. They were treated in The
Centre of thermal trauma and plastic surgery of the Local clinic in Lviv.
According to the analysis of the clinical patients‘ data, the application of the revascular shreds from the
remote areas allows to lay deep hand structures and protect them from further drying out. The application of the
shreds on the alimentary foot provides not only the renewal the skin entity and covering of the deep anatomic
neoplasm of the hand, but also revascularizes them and prevents further necrotisation. Post-surgical period at all
patients‘ treated by this method was smooth and the healing of the wounds was not complicated.
There are less bone and articulate complications at children, who were treated by early plasty with the
shred on the alimentary revascular feet. The children compensate better complications during their growth, than
patients treated by autodermplasty. The method of long immobility, which seems to be rather uncomfortable,
indeed, created any discomfort neither for patients nor for their guardians. Such position of the limb didn‘t cause
any painful feelings and organic changes in elbow or radial and wrist articulations, which could be seen at adults.
According to our observations, the limb immobility at the area of the donor zone by discipline stitches
appeared to be absolutely sufficient for providing the favorable conditions for post-surgical wound healing and
viability of the shred.
Due to the research results it appears that transversal area is the best location, it doesn‘t yield in thick
angioarchitechtonics and provides more physiologic limb position and, accordingly, less risk for the shred bend of
the alimentary foot. The children bore easily the immobilization period and adapted quickly to new opportunities of
their bodies.
We performed repeated degreasing of the shreds only in three cases, where we used large shreds for the
wrist defect covering. The need if inter-surgical shreds‘ degreasing remains discussed in medical literature. Taking
children into consideration, there is no need in degreasing the shred evenly, since in the process of the hand
growth, the thickness of the shred is regulated spontaneously and, taken from the patients‘ examination results in
the remote period, doesn‘t affect the aesthetic look of the hand according to patients‘ views. It turned out that those
who were operated in the early childhood and examined after a period of time after the trauma (6-10 years),
showed normal sensibility to the shreds. The test for discriminating sensibility of the large shred, which covered
three fingers, was positive in one case, but in 4 patients with small shreds on the fingers (up to 1 cm), the
discriminating sensibility became better with time. According to this data, it appears that the plasty with shred
among children from remote areas provides the renewal of sensibility.
Durable limb immobility period and patient‘s stay in the stationary are arguments, which are disadvantages
of the shred plasty on the alimentary revascular feet from remote areas. Thus, even this time cannot be compared
to longer period necessary for multiple hospitalizations among children, who during acute phase of electrotrauma
were treated conservatively or by applying free autodermoplasty.
To sum up, shred plasty at alimentary revascular feet from the remote areas is the best method for treatment
of the electrical hand burns among children.
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